Health Care Systems and Administration of Services
Why do you think (1) hospitals and (2) physicians have invested less in information technology than banks have? What can be done to reduce resistance and encourage adoption?
Every industry has benefitted from the advent of affordable and powerful computer technology, but some have used new technologies to greater advantage than others. Computers have been used to speed up many processes that were completely controlled by humans just a very few years ago. This speed has also come with greater overall efficiency, accuracy, and an incredible amount of savings to the companies which utilize technology (Hare, et al., 2006). But, even though there has been growth in the amount of information technology used by healthcare organizations, it still pales in comparison to other organizations. Especially with the cost to customers generated by healthcare products (drugs, treatments, etc.), it would seem that the industry would be looking for more ways to streamline their operations. However, healthcare organizations, namely physician's offices and hospitals have been resistant to the changes afforded by information technology. The reasons for this resistance are understandable, but the reasons given can be overcome. With the special needs that healthcare organizations have it is no wonder that they resist IT, but they can be assured that technology can adequately assist them even with the challenges that exist.
In 2010, the United States Congress signed legislation which mandated some form of healthcare for every citizen. This is a challenge that has caused the debate over efficiency of healthcare delivery to take center stage. Healthcare is expensive because of the expertise required from practitioners, drug research and development, and the overall cost of many treatments. One of the goals of the new healthcare legislation was to reduce the costs of healthcare delivery (Condon, 2009). However, this is a significant undertaking because with more people added to the insurance roles, there will be that much more work for healthcare providers to do.
People who work in healthcare understand the challenge that the new legislation brings and they are up to the task, but most believe that the easiest way to reduce costs is to adopt new information technologies which can streamline many healthcare processes. The problem with that is primarily two-fold. The largest issue that healthcare organizations such as physicians and hospitals have is the issue of confidentiality. There are many examples of entire databases being hacked, and a multitude of personal information being released. Maintaining the confidentiality of patient records is also federally mandated, and it does not seem to correlate with using electronic means to keep patient personal and health information. It seems that the information can be too easily compromised. There is also the problem of initial cost. Many hospitals run on very small margins, and they do not have the money to absorb the cost of a major IT makeover (Condon, 2009). The second major issue though is that tech support is often either not immediately available or the advice given to fix an issue is not intelligible to nurses or doctors (Condon, 2009). Ease of use is an issue that has plagued computers from their inception, but being able to access information is especially critical for healthcare professionals. The nature of the job makes it critical that professionals be able to access patient records immediately.
Resistance to information technology then is not a surprise. Mainly because of the issue of confidentiality, but also because healthcare organizations have felt in the past that they could not trust the IT support that they were getting. Primarily, IT has been used to give physicians and hospitals instant access to patient histories (Mechanic & Altman, 2010) because that is seen as healthcare biggest IT need. However, the question of security continues to plague the IT industry. Since healthcare reform was passed by Congress, there have been billions of dollars (in stimulus money) spent on improving information technology for healthcare. Ensuring that healthcare professionals had instant access to all of a patient's information has become a priority. Because physicians see the benefits of these new programs, there has been a significant rise in the number of doctor's offices which either partially or fully use an electronic health records program (Health IT, 2010).
One article (Mechanic & Altman, 2010) suggests that the best way to get healthcare organizations to use IT systems for record keeping is through government encouragement, but there are other ways as well. Some estimates say that as much as $12.5 billion could be saved over a period of ten years by switching to electronic record keeping (Condon, 2009). Also, there is the fact that Medicare payments to doctors are going to be cut by 21% over the next several years (Mechanic & Altman, 2010). The fact that the organization can save money, that the systems used are much more secure than they have been in the past and that healthcare organizations stand to lose money they have counted on from government programs should be enough incentive for hospitals and physician's offices to start using electronic medical record keeping.
5. What can we learn from other countries in formulating recommendations to improve the U.S. health care system?
For years people have been saying that the United States healthcare system needs to be fixed, but, in general, they have offered no plausible band aids. The government seems to believe that by borrowing a great deal of money from other countries that it can fix healthcare. Insurance companies work to cut healthcare costs by giving individuals shorter stays in the hospital, and increasing premiums every year or so. Healthcare organizations cut costs by raising prices, when they can, and by performing more procedures at the Medicare and insurance rates. Individuals are thus forced to either pay more for less healthcare, or they drop the healthcare insurance that they had. This has led to the government adopting a deeply flawed healthcare bill, insurance companies becoming increasingly more vilified, healthcare providers having to do more with less, and healthcare recipients getting less while paying more. Surely there is an answer to the healthcare crisis that the United States is facing. Before the country is bankrupted, there has to be a critical look at other countries that have more successfully solved healthcare issues.
Many believe that the best comparison that the United States can make is with European countries and Canada (Hill, 2009). Most of these countries have adopted a social model by which healthcare is guaranteed for all citizens by the government. This means that if any citizen has any type of medical issue they cannot be turned away from medical care because they cannot afford it. Of course, this is also the case in the United States, but that is beside the point. In European countries if an individual must have any type of treatment, from a very minor surgery to something that is both expensive and time-consuming, they must go to a doctor and be referred out for further treatment. The person may have to see several specialists, who are generally overworked and vastly underpaid, and then they have to wait in line for the procedure to be scheduled.
This is the image that many in the U.S. have regarding socialized healthcare (or universal healthcare) in European countries. The facts are not quite as bad as all that. The U.S. healthcare system currently ranks 79 out 191 countries in overall performance (Hill, 2009). The reason for this discrepancy is that many other nations guarantee health care for all of their citizens. These countries also have shorter work weeks, longer paid vacations and other benefits that are designed to improve the health and the quality of life among all citizens. In many countries it has again become standard practice for physicians to make house calls when there is a minor ailment which could be taken care of at home (Hill, 2009). While Us healthcare costs, per family of four, have doubled in the last decade (Strachan, 2011), other countries are seeing overall healthcare costs quickly decrease (Hill, 2009).
The lessons from healthcare in other countries are many and varied. The first lesson is that countries did an overhaul based on data that they gathered from studies designed to see what type of healthcare was needed (Zablit, 2007). Comprehensive studies were conducted to see what areas could be improved and at what cost. The countries that have implemented socialized medicine have also determined something that the U.S. has not. They have realized that healthcare costs are going to be high, so somebody needs to pay for them. Tax rates as high as 80% are not uncommon in European nations because they feel that citizens have the right to certain services that should be paid for by every tax payer. It does not matter what type of job a person has, if they even have a job, or if they are a citizen of that particular country eve. Everyone is guaranteed healthcare at a very low cost (Day,…